Policy Number: Correction of Personal Health Information. Approval Signature: Original signed by A. Wilgosh. Date: April 2010
|
|
- Shauna Porter
- 8 years ago
- Views:
Transcription
1 POLICY REGIONAL Applicable to all WRHA governed sites and facilities (including hospitals and personal care homes), and all funded hospitals and personal care homes. All other funded entities are excluded unless set out within a particular Service Purchase Agreement. Policy Name: Correction of Personal Health Information Approval Signature: Original signed by A. Wilgosh Section: Level: : 1 1 of 6 GENERAL ADMINISTRATION Date: April 2010 Supercedes: May PURPOSE: 1.1 To establish procedures to enable Individuals to request a correction to their Personal Health Information including Demographic Information as set out under The Personal Health Information Act ( PHIA ). 1.2 To establish procedures to process requests to correct Personal Health Information and to accept or refuse those requests. 2.0 DEFINITIONS: 2.1 Access: The right of an Individual, or a Person Permitted to Exercise the Rights of that Individual, to examine (view) and receive a copy of the Individual s Personal Health Information Maintained by the Trustee. 2.2 Complaint: A Complaint made to a Trustee by an Individual and/or by the Provincial Ombudsman about collection, Access, correction, Use, Disclosure, protection, and privacy of Personal Health Information. 2.3 Demographic Information: An Individual s name, address, telephone number and address. 2.4 Disclosure of Personal Health Information: Revealing the Personal Health Information outside the Trustee, i.e. to other Trustees, to family and friends of the Individual, or to other persons legally entitled to have Personal Health Information released to them. 2.5 Health Care: Any care, service or procedure provided to diagnose, treat or Maintain an Individual s health; provided to prevent disease or injury or promote Health Care; or that affects the structure or a function of the body and includes the sale or dispensing of a drug, device, equipment or other item pursuant to a prescription. 2.6 Health Care Facility: A hospital, personal care home, Psychiatric Facility, medical clinic, laboratory, CancerCare Manitoba and community health centre or other facility in which Health Care is provided and that is designated in the PHIA regulations. 2.7 Health Professional: A person who is licensed or registered to provide Health Care under an Act of the Legislature or who is a member of a class of persons designated as Health Professionals in the PHIA regulations.
2 2 of Individual: A patient, client or resident receiving Health Care services within the WRHA/Health Care Facility. For the purposes of Access, correction, Use and Disclosure of Personal Health Information, includes Persons Permitted to Exercise the Rights of an Individual. 2.9 Information Manager: A person or body (corporation, business, or association) that processes, stores or destroys Personal Health Information or provides information management or information technology services for the Trustee Maintain: In relation to Personal Health Information, to have custody or control of the information Personal Health Information: Recorded information about an identifiable Individual that relates to: the Individual s health, or Health Care history, including genetic information about the Individual; the provision of Health Care to the Individual; or payment for Health Care provided to the Individual; and includes: the PHIN (personal health identification number) and any other identification number, symbol or particular assigned to an Individual; and any identifying information about the Individual that is collected in the course of, and is incidental to, the provision of Health Care or payment for Health Care. and for further clarity includes: personal information such as financial position, home conditions, domestic difficulties or any other private matters relating to the Individual which have been disclosed to the Trustee. and for the purpose of the Confidentiality policy: any Personal Health Information exchanged verbally about an identifiable Individual; 2.12 Persons Associated with the WRHA/Health Care Facility includes: all contracted persons, volunteers, students, researchers, WRHA medical staff, educators, members of the Boards of Directors, Information Managers, employees, or agents of any of the above or other health agencies Persons Permitted to Exercise the Rights of an Individual includes: (a) any person with written authorization from the Individual to act on the Individual s behalf; (b) a proxy appointed by the Individual under The Health Care Directives Act;
3 3 of 6 (c) a committee appointed for the Individual under The Mental Health Act if the committee has the power to make Health Care decisions on the Individual s behalf; (d) a substitute decision maker for personal care appointed for the Individual under The Vulnerable Persons Living with a Mental Disability Act, if the exercise of the right relates to the powers and duties of the substitute decision maker; (e) the parent or guardian of an Individual who is a minor, if the minor does not have the capacity to make Health Care decisions; (f) if the Individual is deceased, his or her personal representative If it is reasonable to believe that no person listed in any clause of exists or is available, the adult person listed first in the following who is readily available and willing to act may exercise the rights of an Individual who lacks the capacity to do so: (a) the Individual s spouse or common-law partner, with whom the Individual is cohabiting; (b) a son or daughter; (c) a parent, if the Individual is an adult; (d) a brother or sister; (e) a person with whom the Individual is known to have a close personal relationship; (f) a grandparent; (g) a grandchild; (h) an aunt or uncle; (i) a nephew or niece. Ranking: The older or oldest of two or more relatives described in any clause of is to be preferred to another of those relatives Privacy: The fundamental right of the Individual to control the collection, Use and Disclosure of their Personal Health Information Privacy Officer: An employee designated by the WRHA or the Health Care Facility whose responsibilities include dealing with requests from Individuals who wish to examine and copy or to correct Personal Health Information collected and maintained by the Trustee and facilitating the Trustee s compliance with PHIA. The definition is intended to mean the Privacy Officer and/or their delegate Psychiatric Facility: A place designated in the regulations of The Mental Health Act as a facility for the observation, assessment, diagnosis and treatment of persons who suffer from mental disorders.
4 4 of Record or Recorded Information: A Record of information in any form, and includes information that is written, photographed, Recorded or stored in any manner, on any storage medium or by any means, including by graphic, electronic or mechanical means, but does not include electronic software or any mechanism that produces Records Site: A Health Care Facility, community health centre, community office within the WRHA Trustee: A Health Professional, Health Care Facility, public body, or health services agency that collects or Maintains Personal Health Information. For clarity, the WRHA is the Trustee of the Personal Health Information collected and Maintained within Health Care Facilities and Sites owned and/or operated by the WRHA and includes Community Health Services. The other hospitals and personal care homes within the region are Trustees of the Personal Health Information collected and Maintained at each Health Care Facility Use: Involves revealing Personal Health Information to someone within the Trustee s own organization who needs to know the information to do their job. Use includes processing, reproduction, transmission and transportation of Personal Health Information. 3.0 POLICY: 3.1 The Trustee shall Maintain and adhere to standards to ensure the right of Individuals to request a correction to their Personal Health Information previously accessed by the Individual. 3.2 The Trustee shall respond as promptly as possible, but no later than 30 days after receiving the written request. 3.3 A Trustee shall not charge a fee in connection with a request for a correction to Personal Health Information. 3.4 Requests to correct Personal Health Information recorded in a designated Psychiatric Facility pursuant to The Mental Health Act shall be processed in accordance with the WRHA Policy: Access to, Disclosure of and Corrections to the Clinical Record under The Mental Health Act. 4.0 PROCEDURE: 4.1 Persons associated with the WRHA/Health Care Facility who receives a request from an Individual for the correction of Personal Health Information shall:
5 5 of Refer the Individual to the site Privacy Officer or the WRHA Chief Privacy Officer, or provide the Individual with the Privacy Officer s name, contact address and phone number in writing where applicable; or Forward the completed WRHA Request to Correct Personal Health Information form or written request to the Privacy Officer, where applicable; Document the action taken to facilitate an Individual s request for correction in the Individual s health Record, where applicable. 4.2 The Privacy Officer shall: Obtain the request in writing using the Request to Correct Personal Health Information form, or in a covering letter that includes the written request Respond as promptly as possible, but no later than 30 days after receiving the written request Consult with any of the following when considering the request for correction if there are any questions about the request: Health care professionals who are or have provided Health Care to the Individual; The person who documented the Personal Health Information in the Individual s health Record; Administrative or managerial staff responsible for the service/discipline in question Respond in one of four ways: (a) Add the corrected information to the Record of the Personal Health Information in such a manner that it will be read with and form part of the Record or be adequately cross-referenced to it; (b) Inform the Individual in writing if the information does not exist or cannot be found; (c) Inform the Individual in writing that the Trustee does not Maintain the Personal Health Information and provide them with the name and address of the Trustee who Maintains it; (d) Inform the Individual in writing that the request is refused, in whole or in part, the reason for refusal and advise the Individual of their right to: add a statement of disagreement to the Record, and make a Complaint about the refusal to the Provincial Ombudsman When a correction is made or a statement of disagreement is added, the Privacy Officer shall notify any other Trustee or person to whom the Personal Health Information has been disclosed within the past year.
6 6 of REFERENCES: The notice of correction or statement of disagreement shall be added to any Record of Personal Health Information maintained by the Trustee. 5.1 Access to, Disclosure of and Corrections to the Clinical Record under The Mental Health Act Policy. 5.2 The Personal Health Information Act (Manitoba) 5.3 The Personal Health Information Act Regulations Policy Contact: Landis Esposito, WRHA Chief Privacy Officer
Reporting and Investigating Privacy Breaches and Complaints Approval: Original signed by A. Wilgosh. Date: May 2015
REGIONAL Applicable to all WRHA governed sites and facilities (including hospitals and personal care homes), and all funded hospitals and personal care homes. All other funded entities are excluded unless
More informationHealth Care Directives
Health Care Directives DUNNING PLACE March 2011 Health Care Directives The purpose of this booklet is to outline briefly the law and practice around health care directives. This booklet is a summary and
More informationThe Health Care Directives and Substitute Health Care Decision Makers Act
HEALTH CARE DIRECTIVES AND SUBSTITUTE 1 The Health Care Directives and Substitute Health Care Decision Makers Act being Chapter H-0.001* of the Statutes of Saskatchewan, 1997 (effective September 1, 1997)
More informationGUIDELINE No. 117 THE PHYSICIAN MEDICAL RECORD*
Purpose of Medical Records: GUIDELINE No. 117 THE PHYSICIAN MEDICAL RECORD* The physician s medical record is a reflection of the interaction between a physician and a patient. For each interaction the
More informationHEALTH INFORMATION ACCESS AND PRIVACY. A Guide to The Personal Health Information Act
HEALTH INFORMATION ACCESS AND PRIVACY A Guide to The Personal Health Information Act 1 Your health information is personal and sensitive. Its privacy must be protected. At the same time, you must be able
More informationTechnical Assistance Document 5
Technical Assistance Document 5 Information Sharing with Family Members of Adult Behavioral Health Recipients Developed by the Arizona Department of Health Services Division of Behavioral Health Services
More informationWe ask that you contact our Privacy Officer in the event you have any questions or concerns regarding this Code or its implementation.
PRIVACY AND ANTI-SPAM CODE FOR OUR DENTAL OFFICE Please refer to Appendix A for a glossary of defined terms. INTRODUCTION The Personal Health Information Act (PHIA) came into effect on December 11, 1997,
More information8 July 2015 CRIMINAL JUSTICE (Victims of Crime) BILL 2015 GENERAL SCHEME CONTENTS PART 1 PRELIMINARY. PART 2 Information for Victims
1 P a g e 8 July version Preamble Head 8 July 2015 CRIMINAL JUSTICE (Victims of Crime) BILL 2015 GENERAL SCHEME 1. Short title and commencement 2. Interpretation 3. Expenses CONTENTS PART 1 PRELIMINARY
More informationState of Connecticut Department of Social Services HIPAA Policies and Procedures Manual
State of Connecticut Department of Social Services HIPAA Policies and Procedures Manual Updated 9/17/13 1 Overview As of April 14, 2003, the State of Connecticut Department of Social Services (DSS) is
More informationThe Powers of Attorney Act, 2002
1 POWERS OF ATTORNEY, 2002 c. P-20.3 The Powers of Attorney Act, 2002 being Chapter P-20.3 of the Statutes of Saskatchewan, 2002 (effective April 1, 2003) as amended by the Statutes of Saskatchewan, 2004,
More informationPERSONAL HEALTH INFORMATION PROTECTION ACT, 2004: AN OVERVIEW FOR HEALTH INFORMATION CUSTODIANS
PERSONAL HEALTH INFORMATION PROTECTION ACT, 2004: AN OVERVIEW FOR HEALTH INFORMATION CUSTODIANS Note: This document provides a general overview of the Personal Health Information Protection Act, 2004,
More informationQuestions and answers for custodians about the Personal Health Information Privacy and Access Act (PHIPAA)
Questions and answers for custodians about the Personal Health Information Privacy and Access Act (PHIPAA) This document provides answers to some frequently asked questions about the The Personal Health
More informationSarasota Personal Medicine 1250 S. Tamiami Trail, Suite 202 Sarasota, FL 34239 Phone 941.954.9990 Fax 941.954.9995
Sarasota Personal Medicine 1250 S. Tamiami Trail, Suite 202 Sarasota, FL 34239 Phone 941.954.9990 Fax 941.954.9995 NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY
More informationNOTICE OF PRIVACY PRACTICES Walter Chiropractic Clinic, 5219 Peters Creek Rd Ste 5, Roanoke VA 24019
Effective Date: 5/18/15 NOTICE OF PRIVACY PRACTICES Walter Chiropractic Clinic, 5219 Peters Creek Rd Ste 5, Roanoke VA 24019 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
More informationIntroduction 70. Who can sponsor under the family class? 70. Who can be sponsored in the family class? 70. Can I sponsor if I live outside Canada?
Introduction 70 Who can sponsor under the family class? 70 Who can be sponsored in the family class? 70 Can I sponsor if I live outside Canada? 72 Do I have to financially support the person/s I sponsor?
More informationRehabilitation, Sports & Spine Center, P.S. Notice of Privacy Practices. l. Use and Disclosures of Protected Health Information
Rehabilitation, Sports & Spine Center, P.S. Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
More informationGuilford Medical Associates, P.A.
Page 1 Guilford Medical Associates, P.A. NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
More informationMERCY HEALTH MEDICAL TRANSPORTATION SERVICES PRIVACY NOTICE Revised Notice Effective Date: September 23, 2013
MERCY HEALTH MEDICAL TRANSPORTATION SERVICES PRIVACY NOTICE Revised Notice Effective Date: September 23, 2013 THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
More informationGONZABA MEDICAL GROUP PATIENT REGISTRATION FORM
GONZABA MEDICAL GROUP PATIENT REGISTRATION FORM DATE: CHART#: GUARANTOR INFORMATION LAST NAME: FIRST NAME: MI: ADDRESS: HOME PHONE: ADDRESS: CITY/STATE: ZIP CODE: **************************************************************************************
More informationA Guide. Personal Health Information Protection Act. to the. December 2004. Ann Cavoukian, Ph.D Commissioner
A Guide to the Personal Health Information Protection Act December 2004 Information and Privacy Commissioner/Ontario Ann Cavoukian, Ph.D Commissioner Dr. Ann Cavoukian, the Information and Privacy Commissioner
More informationThe Health Information Protection Act
1 The Health Information Protection Act being Chapter H-0.021* of the Statutes of Saskatchewan, 1999 (effective September 1, 2003, except for subsections 17(1), 18(2) and (4) and section 69) as amended
More informationProvince of Alberta MENTAL HEALTH ACT. Revised Statutes of Alberta 2000 Chapter M-13. Current as of June 12, 2013. Office Consolidation
Province of Alberta MENTAL HEALTH ACT Revised Statutes of Alberta 2000 Current as of June 12, 2013 Office Consolidation Published by Alberta Queen s Printer Alberta Queen s Printer 7 th Floor, Park Plaza
More informationWills, Power of Attorney & Enduring Guardianship
Wills, Power of Attorney & Enduring Guardianship What is a Will? A Will is a written legal document by which the person making it sets out how he or she wishes their property to be distributed after their
More informationPolk Medical Center Notice of Privacy Practices
Polk Medical Center Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
More informationDaughters of Charity Health System Employee Health Insurance Notice of Privacy Practices
Daughters of Charity Health System Employee Health Insurance Notice of Privacy Practices THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS
More informationNOTICE OF PRIVACY PRACTICES OF THE GROUP HEALTH PLANS SPONSORED BY ACT, INC.
NOTICE OF PRIVACY PRACTICES OF THE GROUP HEALTH PLANS SPONSORED BY ACT, INC. THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
More informationBILLING INFORMATION AND ASSIGNMENT OF BENEFITS
BILLING INFORMATION AND ASSIGNMENT OF BENEFITS Facility: Northpoint Radiation Center Pro Physicians Clinic PA Physician: Timothy D. Nichols, M.D. PA, Board Certified Radiation Oncology Wilhelm J. Lubbe,
More informationDeciding About. Health Care A GUIDE FOR PATIENTS AND FAMILIES. New York State Department of Health
Deciding About Health Care A GUIDE FOR PATIENTS AND FAMILIES New York State Department of Health 1 A GUIDE FOR PATIENTS AND FAMILIES Introduction Who should read this guide? This guide is for New York
More informationOUR LADY OF THE LAKE, HOSPITAL INC. AND OUR LADY OF THE LAKE PHYSICIAN GROUP, LLC NOTICE OF PRIVACY PRACTICES
OUR LADY OF THE LAKE, HOSPITAL INC. AND OUR LADY OF THE LAKE PHYSICIAN GROUP, LLC NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
More informationGenetic conditions and insurance. What you need to know and what you need to tell
Genetic conditions and insurance What you need to know and what you need to tell About this booklet This information booklet has been produced to provide accessible and impartial information for people
More informationNotice of Privacy Practices
Notice of Privacy Practices THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
More informationNotice of Privacy Practices Walter L Cohen High School School-based Health Center. Effective as of August 6, 2004
Effective as of August 6, 2004 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. We are required
More informationACKNOWLEDGEMENT OF RECEIPT OF WESTERN DENTAL S NOTICE OF PRIVACY PRACTICE
ACKNOWLEDGEMENT OF RECEIPT OF WESTERN DENTAL S NOTICE OF PRIVACY PRACTICE By signing this document, I acknowledge that I have received a copy of Western Dental s Joint Notice of Privacy Practices. Name
More informationInvoluntary Psychiatric Treatment Act
Involuntary Psychiatric Treatment Act CHAPTER 42 OF THE ACTS OF 2005 as amended by 2008, c. 8, ss. 38, 39; 2010, c. 41, s. 114; 2014, c. 32, ss. 135, 136 2016 Her Majesty the Queen in right of the Province
More informationActing Under a Power of Attorney
Knowledge ~ Compassion ~ Peace of Mind Acting Under a Power of Attorney Two Kinds of Powers of Attorney There are two kinds of Powers of Attorney documents: Power of Attorney for Property; Power of Attorney
More informationFLORIDA MEDICAL CLINIC, P.A. NOTICE OF PRIVACY PRACTICES
FLORIDA MEDICAL CLINIC, P.A. NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW
More informationUndergraduate Admissions. One UTSA Circle JPL 1.01.04 San Antonio, Texas 78249
Undergraduate Admissions The University of Texas at San Antonio One UTSA Circle JPL 1.01.04 San Antonio, Texas 78249 P: 210.458.8000 futureroadrunner@utsa.edu utsa.edu/admissions/transfer The University
More informationCOMPLYING WITH THE PERSONAL HEALTH INFORMATION ACT
COMPLYING WITH THE PERSONAL HEALTH INFORMATION ACT The Personal Health Information Act, S.N.S. 2010, c.41 (referred to as PHIA or the Act ) was passed by the Nova Scotia government on December 10, 2010.
More informationNOTICE OF HEALTH INFORMATION PRIVACY PRACTICES (HIPAA)
NOTICE OF HEALTH INFORMATION PRIVACY PRACTICES (HIPAA) THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
More informationHEALTH INFORMATION ACT
Province of Alberta HEALTH INFORMATION ACT Revised Statutes of Alberta 2000 With amendments in force as of May 16, 2003 Office Consolidation Published by Alberta Queen s Printer Queen s Printer Bookstore
More informationTHIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Notice of Privacy Practices KAISER PERMANENTE NORTHERN CALIFORNIA REGION THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
More informationPRIVACY POLICY (IN ACCORDANCE WITH HIPAA)
PRIVACY POLICY (IN ACCORDANCE WITH HIPAA) The privacy of your medical information is important to us. We understand that your medical information is personal and we are committed to protecting it. This
More informationNOTICE OF PRIVACY PRACTICES. The University of North Carolina at Chapel Hill. UNC-CH School of Nursing Faculty Practice Carolina Nursing Associates
NOTICE OF PRIVACY PRACTICES The University of North Carolina at Chapel Hill UNC-CH School of Nursing Faculty Practice Carolina Nursing Associates THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
More informationForm PPPR 25 Application for review of attorney s decision Section 103, Protection of Personal and Property Rights Act 1988
Form PPPR 25 Application for review of attorney s decision Section 103, Protection of Personal and Property Rights Act 1988 r 406 In the Family Court at [place] FAM No:.. [full name].. [address].. [occupation]
More informationLIST OF SUBSTITUTE DECISION MAKERS WHO MAY GIVE OR REFUSE CONSENT IN RESPECT TO HEALTH CARE MATTERS IF A PERSON IS NOT MENTALLY CAPABLE
LIST OF SUBSTITUTE DECISION MAKERS WHO MAY GIVE OR REFUSE CONSENT IN RESPECT TO HEALTH CARE MATTERS IF A PERSON IS NOT MENTALLY CAPABLE Introduction By: Judith A. Wahl B.A., LL.B. Advocacy Centre for the
More informationAbility to view, download, or print a "Continuity of Care Document" or "Health Summary".
The Salina Pediatric Care patient portal offers secure viewing and communication as a service to patients who wish to view parts of their records and communicate with our staff. This can be a valuable
More informationGeneral Instructions for the Legal Requirements Checklists for Adult Patients and Glossary
General Instructions for the Legal Requirements Checklists for Adult Patients and Glossary The MOLST form is a medical order form that tells others the patient s medical orders for lifesustaining treatment.
More informationNOTICE OF PRIVACY PRACTICES FOR THE NORTH CENTRAL NURSING CLINICS
NOTICE OF PRIVACY PRACTICES FOR THE NORTH CENTRAL NURSING CLINICS This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please
More informationHEALTH INFORMATION ACT
Province of Alberta HEALTH INFORMATION ACT Revised Statutes of Alberta 2000 Current as of June 17, 2014 Office Consolidation Published by Alberta Queen s Printer Alberta Queen s Printer 7 th Floor, Park
More informationNEW PATIENT APPLICATION. Welcome to Corrective Chiropractic! Please answer all questions to the best of your ability. Thank you.
NEW PATIENT APPLICATION Welcome to! Please answer all questions to the best of your ability. Thank you. Today s Date: Address: City/State/Zip: E-Mail: Cell: (H): (W): Fax: Birth date: / / Age: Marital
More informationSection A Victim/Applicant Information (A separate application must be completed for each victim.)
Application For Crime Victim Compensation Claim No. Arkansas Crime Victims Reparations Board 323 Center Street, Suite 200 Little Rock, Arkansas 72201 Office of the (501) 682-1020 or 1-800-448-3014 This
More informationJEWISH FAMILY SERVICE NOTICE OF PRIVACY PRACTICES
Jewish Family Service takes pride in treating our clients and each other with respect and dignity. Protecting your health information is very important to us. We want you to have a clear understanding
More informationNOTICE OF PRIVACY PRACTICES
GLOUCESTER COUNTY PUBLIC SCHOOLS EMPLOYEE HEALTH CARE PLAN, GLOUCESTER COUNTY PUBLIC SCHOOLS EMPLOYEE DENTAL CARE PLAN, GLOUCESTER COUNTY PUBLIC SCHOOLS EMPLOYEE FLEXIBLE BENEFITS PLAN 1 NOTICE OF PRIVACY
More informationNOTICE OF PRIVACY PRACTICES FOR ORTHOPAEDIC SURGERY & REHAB. ASSOCIATES, P.C.
NOTICE OF PRIVACY PRACTICES FOR ORTHOPAEDIC SURGERY & REHAB. ASSOCIATES, P.C. Effective date: April 14, 2003 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW TO
More informationNOTICE OF PRIVACY PRACTICES FOR OUR PATIENTS POTOMAC PHYSICIAN ASSOCIATES, P.C.
NOTICE OF PRIVACY PRACTICES FOR OUR PATIENTS POTOMAC PHYSICIAN ASSOCIATES, P.C. THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
More informationThe Manitoba Child Care Association PRIVACY POLICY
The Manitoba Child Care Association PRIVACY POLICY BACKGROUND The Manitoba Child Care Association is committed to comply with the legal obligations imposed by the federal government's Personal Information
More informationPersonal Contact and Insurance Information
Kenneth A. Holt, M.D. 3320 Executive Drive Tele: 919-877-1100 Building E, Suite 222 Fax: 919-877-8118 Raleigh, NC 27609 Personal Contact and Insurance Information Please fill out this form as completely
More informationTrustee Training. Special Service Districts
Trustee Training Special Service Districts Outline Governing Board Responsibilities Ethics Nepotism Meetings Minutes Agendas GRAMA Insurance Contact Information 2 Management Responsibilities Effectiveness
More informationHIPAA Omnibus Notice of Privacy Practices Effective Date: March 03, 2012 Revised on: July 1, 2015
HIPAA Omnibus Notice of Privacy Practices Effective Date: March 03, 2012 Revised on: July 1, 2015 Mobile Physician Group PC 231 High Street Suite 1, Mount Holly, NJ 08060 1-855-MPG-DOCS THIS NOTICE DESCRIBES
More informationHIPAA NOTICE OF PRIVACY PRACTICES
HIPAA NOTICE OF PRIVACY PRACTICES Marden Rehabilitation Associates, Inc. Marden Rehabilitation Associates of Ohio, Inc. Marden Rehabilitation Associates of West Virginia Health Care Plus Preferred Care
More informationSTANDARDS OF PRACTICE (2013)
STANDARDS OF PRACTICE (2013) COLLEGE OF ALBERTA PSYCHOLOGISTS STANDARDS OF PRACTICE (2013) 1. INTRODUCTION The Health Professions Act (HPA) authorizes and requires the College of Alberta Psychologists
More informationREGISTRATION FEE REIMBURSEMENT PLAN
REGISTRATION FEE REIMBURSEMENT PLAN The terms and conditions of the Registration Fee Reimbursement Plan (herein called the Plan ) described below apply to the event for which you have registered and that
More informationNotice of Privacy Practices
Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. About this notice
More informationHIPAA Notice of Privacy Practices - Sample Notice. Disclaimer: Template Notice of Privacy Practices (45 C.F.R. 164.520)
HIPAA Notice of Privacy Practices - Sample Notice Disclaimer: Template Notice of Privacy Practices (45 C.F.R. 164.520) The information provided in this document does not constitute, and is no substitute
More informationKAISER PERMANENTE SOUTHERN CALIFORNIA REGION
Notice of Privacy Practices KAISER PERMANENTE SOUTHERN CALIFORNIA REGION THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
More informationNOTICE OF PRIVACY PRACTICES ILLINOIS EYE CENTER
NOTICE OF PRIVACY PRACTICES ILLINOIS EYE CENTER THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
More informationHow To Protect Your Privacy
Community Health of South Florida, Inc. 10300 SW 216 th Street Miami, FL 33190 Effective Date: April 2003 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
More informationPlanning for incapacity using a power of attorney
Advisory Planning for incapacity using a power of attorney It is possible that at some point in our lives we may become incapable of making decisions for ourselves, either temporarily or permanently, due
More informationFloyd Healthcare Management, Inc. Notice of Privacy Practices
Floyd Healthcare Management, Inc. Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW
More informationHealth Care Consent Act
Briefing Note 2005, 2007 College of Physiotherapists of Ontario 2009 Contents Overview...3 Putting the in Context...3 The HCCA in Brief...4 Key Principles Governing Consent to Treatment...4 Key Aspects
More informationAssociates in Urology, LLC Notice of Privacy Practices
Associates in Urology, LLC Notice of Privacy Practices Associates in Urology, LLC 741 Northfield Avenue, Suite 206 West Orange, New Jersey 07052 By using this website, you agree to the privacy notice as
More informationCounty of Ocean, New Jersey. Jeffrey W. Moran, Surrogate 118 Washington Street, P. O. Box 2191 Toms River, NJ 08754-2191 - Phone: 732-929-2011
County of Ocean, New Jersey Jeffrey W. Moran, Surrogate 118 Washington Street, P. O. Box 2191 Toms River, NJ 08754-2191 - Phone: 732-929-2011 A PLANNING GUIDE TO THE PROBATE PROCESS The Probate Process
More informationPURPOSE AND SCOPE This table is applicable to all UW Medicine Compliance Policies governing privacy.
Applicability: Policy Title: Policy Number: Glossary of s PP-00 Superseded Policy(ies) or Entity Policy: N/A Date Established: October 27, 2003 Date Effective: September 21, 2015 Dates Revised: November
More informationPOLICY STATEMENT 5.17
POLICY STATEMENT 5.17 DENTAL RECORDS 1 (Including ADA Guidelines for Dental Records) 1. Introduction 1.1 Dentists have a professional and a legal obligation to maintain clinically relevant, accurate and
More information650 Clark Way Palo Alto, CA 94304 650.326.5530
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. (Adopted 4-14-03; revised December 2006) If
More informationTHIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Notice of Privacy Practices KAISER PERMANENTE COLORADO REGION THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW
More informationNorth Florida Medical Centers, Inc. Notice of Information Practices
North Florida Medical Centers, Inc. Notice of Information Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
More informationPRIVACY HIPAA NOTICE OF PRACTICE
PRIVACY HIPAA NOTICE OF PRACTICE Bux-Mont Allergy & Asthma, L.L.C. NOTICE OF PRIVACY PRACTICES Effective date: September 23, 2013 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
More informationNORTHSTAR DERMATOLOGY, PA NOTICE OF PRIVACY PRACTICES
NORTHSTAR DERMATOLOGY, PA NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT
More informationCOLLECTION, USE AND DISCLOSURE
COLLECTION, USE AND DISCLOSURE The full title of the Personal Health Information Act is An Act Respecting the Collection, Use, Disclosure and Retention of Personal Health Information. The title underscores
More informationCanadian Health Insurance. The Medical Expense Tax Credit. Life s brighter under the sun. June 2012. health plans
Canadian Health Insurance tax Guide June 2012 Life s brighter under the sun Sun Life Assurance Company of Canada, 2012. Individuals may not deduct hospital and medical expenses from their income, but they
More informationCentral Maine Healthcare
Central Maine Healthcare Administrative Policy No. HC-HI-5004(R2) HIPAA SUBJECT: Disclosures of Protected Health Information Policy Statement/Purpose: This policy sets forth the circumstances in which
More informationNOTICE OF PATIENT RIGHTS AND PRIVACY PRACTICES
1303 NE Cushing Dr. Suite 200 Bend, Oregon 97701 Phone (541) 318-0858 Fax (541) 318-6740 NOTICE OF PATIENT RIGHTS AND PRIVACY PRACTICES THIS INFORMATION IS PROVIDED TO YOU BY BEND SURGERY CENTER THIS NOTICE
More informationREPRODUCTIVE BIOLOGY ASSOCIATES, LLP HIPAA MANUAL NOTICE OF PRIVACY PRACTICES
NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. OUR PLEDGE TO YOU: Reproductive
More informationHow to Prepare Patient Health Information Without a Photo ID
Patient Health Information For Tax Reporting When patients or clients ask you for their account statement information, take the time to ask them for photo ID and a proper authorization to disclose their
More informationHIPAA NOTICE OF PRIVACY PRACTICES Woodlands Behavioral Healthcare Network (WBHN)
HIPAA NOTICE OF PRIVACY PRACTICES Woodlands Behavioral Healthcare Network (WBHN) Effective Date: 04/14/15 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
More informationNOTICE OF PRIVACY PRACTICES effective April 14, 2003
NOTICE OF PRIVACY PRACTICES effective April 14, 2003 This document outlines the privacy practices of Dental Clinic of Marshfield S.C. and Dental Com Insurance Plan, Inc. All references to Dental Clinic
More informationACKNOWLEDGMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES
ACKNOWLEDGMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES I acknowledge that I have been provided a copy of Fiorillo Cosmetic and General Dentistry s Notice of Privacy Practices, which has an effective
More informationIF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE OR IF YOU NEED MORE INFORMATION, PLEASE CONTACT OUR PRIVACY OFFICER:
NOTICE OF PRIVACY PRACTICES COMPLETE EYE CARE THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
More informationTEXAS FAMILY CODE CHAPTER 32. CONSENT TO TREATMENT OF CHILD BY NON PARENT OR CHILD
TEXAS FAMILY CODE CHAPTER 32. CONSENT TO TREATMENT OF CHILD BY NON PARENT OR CHILD SUBCHAPTER A. CONSENT TO MEDICAL, DENTAL, PSYCHOLOGICAL, AND SURGICAL TREATMENT 32.001. Consent by Non-Parent (a) The
More informationStrategies for Electronic Exchange of Mental Health Records
Strategies for Electronic Exchange of Mental Health Records John Lunstroth, J.D., LL.M., M.P.H. Allison Winnike, J.D. Prepared for the Texas Health and Human Services Commission and the Texas Health Services
More informationDuties and Powers of a Personal Attorney in Saskatchewan
Duties and Powers of a Personal Attorney in Saskatchewan DUNNING PLACE 7068_mjag_PGT-Duties and Powers of a Personal Attorney.indd 1 7068_mjag_PGT-Duties and Powers of a Personal Attorney.indd 2 Table
More informationLet s talk about Intestacy. If you die without a valid Will you are said to have died intestate.
Let s talk about Intestacy If you die without a valid Will you are said to have died intestate. Our Vision and Mission To be Queensland s best provider of trustee and administration services. To deliver
More informationNOTICE OF PRIVACY PRACTICES
NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCL OSE D AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. B ACK GR OUND
More informationStrategies for Electronic Exchange of Substance Abuse Treatment Records
Strategies for Electronic Exchange of Substance Abuse Treatment Records Patricia Gray, J. D., LL. M. Prepared for the Texas Health and Human Services Commission and the Texas Health Services Authority
More informationHow To Manage A Major International Event
New South Wales Sydney 2009 World Masters Games Organising Committee Act 2005 No 65 Contents Part 1 Part 2 Part 3 Preliminary Page 1 Name of Act 2 2 Commencement 2 3 Definitions 2 Constitution of SWMGOC
More information1. Glossary Some information in this factsheet is quite technical. This glossary gives an explanation of some of the phrases and words that are used:
Nearest Relative This factsheet looks at the role of the nearest relative. This is a term used in the Mental Health Act. It covers who someone s nearest relative would be, what the nearest relative s rights
More informationUnderstanding Personal Directives
Understanding Personal Directives Table of Contents Introduction... 2 What is a personal directive?...2 Why is a personal directive necessary?...2 Is a personal directive as important as a Will?...2 Is
More informationSupplement No. 4 published with Extraordinary Gazette No. 41 dated 17 th May, 2013. THE MENTAL HEALTH LAW, 2013 (LAW 10 OF 2013)
CAYMAN ISLANDS Supplement No. 4 published with Extraordinary Gazette No. 41 dated 17 th May, 2013. THE MENTAL HEALTH LAW, 2013 (LAW 10 OF 2013) THE MENTAL HEALTH LAW, 2013 ARRANGEMENT OF SECTIONS 1. Short
More informationHIPAA-ACKNOWLEDGEMENT OF RECEIPT Notice of Privacy Practices
PEDIATRIC ENDOCRINE ASSOCIATES, P.C. 8200 E. Belleview Avenue, Suite 510E Greenwood Village, CO 80111 303-783-3883 HIPAA-ACKNOWLEDGEMENT OF RECEIPT Notice of Privacy Practices Printed Patient Name: Patient
More information